Spinal fixation system

ABSTRACT

An alignment assembly for aligning and positioning an interbody plate over a disc space in between two adjacent vertebrae, the assembly including: a fastener having a long axis and a plate engagement including opposed wings converging towards the axis; and a mate for the fastener configured to receive the fastener thereover at a first end and having a releasable connector with a releasable attachment below the first end; wherein the fastener is releasably secured to the mate for the fastener as it moves therealong; and wherein during use the opposed wings contact one or more edges of an aligning aperture of the interbody plate thereby bringing the interbody plate into alignment with the fastener.

FIELD OF THE INVENTION

The invention relates to a spinal fixation system and method of use. Inparticular, the invention relates, but is not limited, to a spinalfixation system and method of use associated with vertebrae fusion.

BACKGROUND TO THE INVENTION

Reference to background art herein is not to be construed as anadmission that such art constitutes common general knowledge inAustralia or elsewhere.

Spinal fusion surgery is intended to prevent the movement of painfulvertebrae. In particular, spinal fusion surgery limits motion betweenadjacent vertebrae by creating a fusion environment therebetween.

A common method of stabilising and limiting the motion between adjacentvertebrae is, after the insertion of an intervertebral cage, securing aplate to an anterior face of the adjacent vertebrae. Securing the plateto the vertebrae normally involves screwing fasteners, through aperturesin the plate, into prepared holes in the vertebrae.

A problem associated with implantation of the plate is temporarilysecuring and aligning the plate during the initial plate insertion andscrewing of the fasteners. Movement of the plate, either duringinsertion or fastening, can jeopardise precise placement of the plate.This may lead to further complication including, for example, thefasteners or plate coming into contact with adjacent structures thatmay, for instance, be neural or vascular.

OBJECT OF THE INVENTION

It is an aim of this invention to provide a spinal fixation system andmethod of use which overcomes or ameliorates one or more of thedisadvantages or problems described above, or which at least provides auseful alternative.

Other preferred objects of the present invention will become apparentfrom the following description.

SUMMARY OF INVENTION

In one form, although not necessarily the only or broadest form, theinvention resides in a spinal fixation system, the system including:

an alignment assembly comprising:

-   -   a fastening element; and    -   a mating element configured to receiving the fastening element        thereover and having a releasable connector; and

a fixation assembly comprising:

-   -   a plate having an aligning aperture that allows the mating        element to be received therethrough; and    -   an implant configured to be received between adjacent vertebrae        and releasably connect with the releasable connector,    -   wherein the fastening element is configured to move along the        mating element to engage with the plate.

Preferably, the fastening element includes an aperture therethrough.Normally, the aperture includes an engagement portion. Typically, theengagement portion engages with the mating element to releasably securethe fastening element as it moves along the mating element.

Preferably, releasably securing the fastening element as it moves alongthe mating element assists in locking the fastening element in alocation relative to the mating element. Preferably, releasably securingthe fastening element as it moves along the mating element allows aclamping force to be applied to the plate.

Preferably, the engagement portion is in the form of a thread. In analternative form, the engagement portion is configured to provide apress fit along the mating element.

Preferably, the fastening element includes an upper body and a lowerbody. Typically, the upper body includes a driver engagement portion.Normally, the driver engagement portion is a hex head.

Preferably, the lower body includes a plate engagement portion.Typically, the plate engagement portion is configured to engage theplate to centralise the plate about the mating element. Preferably, theplate engagement portion is configured to centralise the plate in adirection between adjacent vertebrae. That is, normally the plateengagement portion is configured to centralise the plate in alongitudinal direction. Normally, the longitudinal direction is in adirection along the spine of a patient.

Preferably, the plate engagement portion includes one or more wingportions. Normally, the one or more wing portions engage with the plate.Normally, the one or more wing portions extend from a central part ofthe lower portion.

Preferably, the one or more wing portions converge towards an axial axisof the fastening element. Typically, the one or more wing portionslinearly converge towards the axial axis of the fastening element. Inanother form, the one or more wing portions non-linearly convergetowards the axial axis of the fastening element.

Preferably, in response to one wing portion engaging with a front and/orrear wall of the aligning aperture in the plate, the plate is configuredto shift in a direction towards another wing portion.

Preferably, the mating element includes a body having a first end toreceive the fastening element thereover. Normally, the body includes aretaining portion. Typically, the first end is a free end with a crosssectional area substantially the same or smaller than the retainingportion.

Preferably, the retaining portion is configured to engage with theengagement portion to releasably secure the fastening element to themating element. Typically, the retaining portion extends from at or nearthe first end towards the releasable connector. Preferably, theretaining portion is in the form of a thread.

Preferably, the body includes a front portion, a rear portion and twoside portions. Typically, one or more of the side portions include asubstantially flat part. Preferably, the front portion and/or the rearportion include a substantially circular part. Normally, the frontportion and/or rear portion include the retaining portion.

Preferably, a distance between the two side portions is smaller than adistance between the front portion and the rear portion. Normally, thedistance between the two side portions is substantially the same as adistance between sidewalls in the aligning aperture of the plate.Preferably, the distance between the front portion and the rear portionis smaller than a distance between a front wall and a rear wall in thealigning aperture of the plate.

Preferably, the body includes an aperture therethrough. Typically, theaperture is configured to receive the releasable connector.

Preferably, the releasable connector includes a releasably attachingportion. Normally, the releasably attaching portion releasably connectswith the implant. Typically, the releasably attaching portion includes athreaded part. In a further form, the releasably attaching portion pressfits into the implant.

Typically, the releasably attaching portion is located below the firstend of the body. Normally, the releasably attaching portion is locatedbelow the retaining portion of the body. Preferably, the releasablyattaching portion is located adjacent to a second end of the body.

Preferably, the releasable connector includes a shaft that is connectedbetween the releasably attaching portion and a head portion. Normally,the head portion is located above the body. Preferably, the head portionis configured to receive a socket. Typically, the head portion includesa hexagonal section.

Preferably, the releasable connector is configured to move relative tothe body. Normally, the releasable connector is configured to movebetween a first position to a second position. Preferably, in the firstposition, the releasably attaching portion is engaged with the body.Typically, in the second position, the head portion is engaged with thebody.

Preferably, the plate includes a first aperture, a second aperture, athird aperture and/or a fourth aperture located about the aligningaperture.

Typically, the first aperture, the second aperture, third apertureand/or fourth aperture are inclined from a top face of the plate to abottom face of the plate.

Preferably, the bottom face of the plate is configured to be locatednext to the adjacent vertebrae.

Typically, the implant is a spinal implant. Normally, the implant is inthe form of a spinal fusion cage. Preferably, the implant includes areleasable fixing portion.

Preferably, the releasable fixing portion is configured to releasablyconnect to the releasably attaching portion. Preferably, the releasablefixing portion includes a thread.

In another form the invention resides in an alignment assembly, thealignment assembly including:

a fastening element; and

a mating element configured to receive the fastening element thereoverat a first end and having a releasable connector with a releasablyattaching portion below the first end,

wherein the fastening element is releasably secured to the matingelement as it moves therealong.

Preferably, the releasably attaching portion is located at or next to asecond end of a body of the mating element.

Preferably, the alignment assembly is as described herein.

In another form the invention resides in a mating element, the matingelement including:

a body having a first end configured to receive a fastening elementthereover; and

a releasable connector having a releasably attaching portion that islocated below the first end,

wherein the body is configured to releasably secure the fasteningelement as it moves therealong.

Preferably, the mating element is as described herein.

In another form the invention resides in a method for spinal fixation,the method including the steps of:

positioning an implant between adjacent vertebrae;

releasably connecting a mating element to the implant;

moving a plate along the mating element to be next to the adjacentvertebrae;

moving a fastening element along the mating element to engage with theplate in order to assist in restricting movement of the plate.

Preferably, the step of connecting the mating element to the implantincludes moving the mating element towards the implant whilst it isconnected to a first driver.

Typically, the step of connecting the mating element to the implantincludes moving a releasably attaching portion along a releasable fixingportion. Normally, the step of moving the releasably attaching portionalong the releasable fixing portion includes turning the releasablyattaching portion along the releasable fixing portion.

Preferably, the step of moving the plate along the element to be next tothe adjacent vertebrae includes substantially engaging sidewalls of analigning aperture in the plate with side portions of the mating element.

Preferably, the step of moving the fastening element along the matingelement to engage with the plate in order to assist in restrictingmovement of the plate includes first disconnecting the first driver fromthe mating element.

Normally, the step of moving the fastening element along the matingelement to engage with the plate in order to assist in restrictingmovement of the plate includes moving the fastening element towards theplate whilst it is connected to a second driver.

Preferably, the step of moving the fastening element along the matingelement to engage with the plate in order to assist in restrictingmovement of the plate includes moving an engagement portion of thefastening element along a retaining portion of the mating element.

Typically, the step of moving the engagement portion of the fasteningelement along the retaining portion of the mating element includesturning the engagement portion along the retaining portion.

Preferably, the step of moving the fastening element along the matingelement to engage with the plate in order to assist in restrictingmovement of the plate includes engaging a first wing of the fasteningelement with a front wall and/or a rear wall of the aligning aperture inthe plate.

Preferably, in response to engaging the first wing of the fasteningelement with the front wall or rear wall of the aligning aperture in theplate, the method further includes moving the fastening element furtheralong the mating element to engage a second wing of the fasteningelement with the front wall or rear wall that was not engaged by thefirst wing.

Preferably, the method further includes preparing holes in the adjacentvertebrae whilst using one or more apertures in the plate as a guide.

Preferably, the method further includes fastening screws into thevertebrae through the one or more apertures in the plate. Preferably,the step of fastening screws into the vertebrae through apertures in theplate includes fastening the screws into said prepared holes of thevertebrae.

Preferably, the method further includes removing the mating element withthe first driver whilst the fastening element is connected thereto.

Further features and advantages of the present invention will becomeapparent from the following detailed description.

BRIEF DESCRIPTION OF THE DRAWINGS

By way of example only, preferred embodiments of the invention will bedescribed more fully hereinafter with reference to the accompanyingfigures, wherein:

FIG. 1 illustrates a spinal fixation system, according to an embodimentof the invention;

FIG. 2 illustrates a front view of a fastening element, shown in FIG. 1,according to an embodiment of the invention;

FIG. 3 illustrates a section view of the fastening element shown in FIG.2;

FIG. 4 illustrates a front view of a mating element, shown in FIG. 1,according to an embodiment of the invention;

FIG. 5 illustrates a section view of the mating element shown in FIG. 4;

FIG. 6 illustrates a side view of the mating element shown in FIG. 4;

FIG. 7 illustrates a front view of a first driver, according to anembodiment of the invention, with the mating element shown in FIG. 4connected thereto;

FIG. 8 illustrates a cross section sectional view of the first driverand mating element shown in FIG. 7;

FIG. 9 illustrates a front view of a second driver, according to anembodiment of the invention, with the fastening element shown in FIG. 2connected thereto; and

FIG. 10 illustrates a cross section sectional view of the second driverand fastening element shown in FIG. 9.

DETAILED DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a spinal fixation system 10, according to anembodiment of the invention. The spinal fixation system 10 includes analignment assembly 20 and a fixation assembly 30. As will be appreciatedby a person skilled in the art, the fixation assembly 30 in thisembodiment remains in a patient after surgery to assist with fusingadjacent vertebrae whilst, as outlined further below, the alignmentassembly 20 temporarily assists in aligning components of the fixationassembly 30 during surgery.

The alignment assembly 20 includes a fastening element 100 and a matingelement 200. A front view of the fastening element 100, according to anembodiment of the invention, is shown FIG. 2. A cross-sectional view ofthe fastening element 100, along the line A-A in FIG. 2, is shown inFIG. 3.

As shown in FIGS. 2 and 3, the fastening element 100 includes an upperbody 120 and a lower body 140. The upper body 120 includes a driverengagement portion 122. In this embodiment, the driver engagementportion 122 is in the form of a hex head. The upper body 120 alsoincludes a clip 124. The clip 124 is a circlip that is locatedsubstantially around the upper body 120. As shown further in FIG. 3, theupper body includes an aperture 126 therethrough. The aperture 126includes an engagement portion 128. It would be appreciated by a personskilled in the art the engagement portion 128 may extend into the lowerbody 140 or be located in the lower body 140 alone. The engagementportion 128 is in the form of a thread in this embodiment.

The upper body 120 is connected to the lower body 140 via a clip 150 inthe form of a circlip. That is, the clip 150 is located between ashoulder on the upper body 120 and a recess located in the lower body140. It would be appreciated that the upper body 120 and lower body 140may be releasably connected through other methods including a press fit.In a further embodiment, the upper and lower body 120, 140 may also beintegrally formed.

The lower body 140 includes a plate engagement portion 142. The plateengagement portion 142 in this embodiment includes wings 144. The wings144 include a bearing surface 146 that converges towards an axial axis(e.g. an axis coinciding with section line A-A). In this regard, thebearing surfaces 146 extend transversely to the axial axis. The bearingsurfaces 146 are angled at approximately 45 degrees to the axial axis inthis embodiment.

The lower body 140 also includes an aperture 148 therethrough which isaligned with the aperture 126. It would is appreciated the apertures126, 148 collectively define an aperture through the fastening element100.

As shown in FIGS. 4 to 6, the mating element 200 includes a body 220 anda releasable connector 240. The body 220 includes a front portion 222, arear portion 224 and two side portions 226.

The front portion 222 and the rear portion 224 include a substantiallycircular part in this embodiment. The circular part includes a retainingportion 227 in the form of a thread. The retaining portion 227 islocated next to a first end of the body 220. It would be appreciatedthat the first end of the body 220 is a free end which is shaped thesame size or smaller than the retaining portion 227. According, thefirst end does not provide a barrier or alike to accessing the retainingportion 227 when an object is moved thereover. The retaining portion 227is configured to engage with the engagement portion 128 to releasablysecure the fastening element 100 to the body 220.

The two side portions 226 are substantially flat in this embodiment. Thedistance between the two side portions 226 is smaller than the distancebetween the front portion 222 and the rear portion 224.

The body 220 also includes an aperture 228 therethrough. The aperture228 extends in a longitudinal direction along the body 220. The aperture228 includes a first cross-sectional area that is smaller than a secondcross-sectional area. The releasable connector 224 is received into theaperture 228.

The releasable connector 224 includes a head portion 242 and areleasably attaching portion 246. The head portion 242 includes adriving portion 244. The releasably attaching portion 246 includes athreaded portion. A shaft 248 connects the head portion 242 to thereleasably attaching portion 246. The head portion 242 is located abovethe body 220. The head portion 242 is located adjacent to the first endof the body 220. The releasably attaching portion 246 is located at ornear the second end of the body 220.

The cross-sectional area of the head portion 242 and releasablyattaching portion 246 is greater than the shaft 248. In this regard, inorder to retain the releasable connector 224 in the aperture 228, thehead portion 242 and attaching portion 246 are located on either side ofthe first cross-sectional area of the aperture 228 whilst the shaft 248extends therealong.

With the above in mind, the releasable connector 224 is configured tomove from a first position to a second position. In particular, thereleasable connector moves from a first position where the head portion242 engages the body 220 to a second position where the releasablyattaching portion 246 engages a shoulder in the aperture 228 of the body220.

The fixation assembly 30 includes a plate 300 and an implant 400. Theplate 300 includes a plurality of apertures 310. The plurality ofapertures 310 include four apertures located near the corners of theplate 300, in this embodiment. The plurality of apertures 310 areinclined from a top face of the plate 300 to a bottom face of the plate300. The plurality of apertures 310 are configured to receive fasteners(i.e. screws) therethrough, to engage prepared holes in the vertebrae,in order to secure the plate 300 next to the vertebrae. Accordingly, thebottom face of the plate 300 is formed to be located next to thevertebrae.

The plate 300 also includes an aligning aperture 320. The aligningaperture 320 is centrally located in the plate 300 in this embodiment.In this regards, the aligning aperture 320 is located substantiallyinboard from the apertures 310. The aligning aperture 320 includes frontwall 322, rear wall 324 and sidewalls 326. The walls 322, 324, 326includes an upper gradient surface.

The distance between the sidewalls 326 is substantially the samedistance between the side portions 226. Normally, the distance betweenthe front wall 322 and rear wall 324 is larger or smaller than thedistance between the front portion 222 and the rear portion 224 but, asoutlined further below, this is dependent on the size of the plate 300and the distance between the adjacent vertebrae.

The implant 400 is in the form of an interbody cage for spinal fusion.The implant 400 includes a body 410 having an aperture 420 therethrough.The aperture 420 includes a releasably fixing portion 430. The body 410also includes a plurality of ridges 440, on either side of the body 410,that sit adjacent the upper and lower vertebrae.

FIGS. 7 and 8 illustrate a first driver 500, according to an embodimentof the invention. The first driver 500 includes an elongate member 520and a grip 540. The elongate member 520 includes a handle 522 and ashaft 524. The handle 522 is located at one end of the shaft 522 and anaperture is located at another end of the shaft 522. The aperture in theshaft 522 is configured to receive the mating element 200 therein andengage with the driving portion 244. The grip 540 includes a handle 542and a hollow protrusion 544. The shaft 522 of the elongate member 520extends through the handle 542 and the hollow protrusion 544. The grip540 may engage with the retaining portion 227.

FIGS. 8 and 9 illustrate a second driver 600. The second driver 600includes a grip 610 and a shaft 620. The grip 620 is located at one endof the shaft 620 and an aperture is located at another end. The apertureat the end of the shaft 620 is configured to receive the fasteningelement 100 therein and engaged with the driver engagement portion 122.

In use, a portion of a disc between adjacent vertebrae is removed.Following this, the implant 400 is implanted between the adjacentvertebrae.

To temporarily fasten the mating element 200 with the implant 400, themating element 200 is first loaded into the first driver 500, as shownin FIGS. 7 and 8. In this regard, the aperture of the shaft 522 receivesthe driving portion 244.

The releasably attaching portion 246 of the mating element 200 is theninserted and fastened to the releasably fixing portion 430 of theimplant 400. It would be appreciated that to fasten the releasablyattaching portion 246 to the releasably fixing portion 430, the shaft522 is rotated, with the mating element 200 at one end, whilst the grip540 is held relatively fixed.

Once the mating element 200 is releasably fasten to the implant 400, theplate 300 is then moved along (i.e. over) the mating element 200. In thepresent embodiment, as the plate 300 passes over the mating element 200,the plate 300 is centralised in a first direction (e.g. a lateraldirection) between the sidewalls 326 thereof and the two side portions226 of the mating element 200. This is due to the distance between thetwo side portions 226 and the sidewalls 326 of the plate 300 beingsubstantially the same.

The plate 300 is moved down along the mating element 200 until it ispositioned adjacent to the implant 400. In this regard, the plate 300 isposition next to the adjacent vertebrae.

Following the above, the fastening element 100 is moved such that theengagement portion 128 of the fastening element 100 engages theretaining portion 227 of the mating element 200. The fastening element100 is then moved along the mating element 200 by turning the fasteningelement 100. It would be appreciated that the fastening element 100 isturned with the second driver 600 which engages the engagement portion122 of the fastening element 100. As the fastening element 100 movesalong the mating element 200, the mating element 200 is received intothe aperture of the shaft 620.

The fastening element 100 is moved along the mating element 200 toengage with the plate 300 such that the plate 300 is centralised in asecond direction (i.e. a longitudinal direction along the spine). Thatis, as the fastening element 100 is moving along the mating element 200,a bearing face 146 of one wing 144 will come into contact with eitherthe front wall 322 or rear wall 324 of the plate 300. In response tocontacting one of the bearing faces 146 of the wings 144, the plate 300is shifted in a direction along the wing 144 (i.e. the bearing face 146)as the fastening element 100 is further moved along the mating element200. This in turn results in plate 300 moving to a centralised locationabout the mating element 200 and contacting the other wing 144. Once theplate 300 is in contact with both wings 144 (i.e. the bearing faces146), it is substantially centralised about the mating element 200 andsecured in place.

To further elaborate on the above, assuming one of the wings 144 comesinto contact with the front wall 322 of the plate 300 first, by way ofexample, as the fastening element 100 is moved along the mating element200. This will result in the front wall 322 sliding along the wing 144which in turn will shift the plate 300 upwards/forwards along thelongitudinal axis of the spine. As the fastening element 100 continuesto be moved along the mating element 200, the other wing 144 will thencome into contact with the rear wall 324 of the plate. As the fasteningelement is tightened between the plate 300 and mating element 200, thewings 144 will cause the plate 300 to centralise about the matingelement 200. That is, the plate 300 is moved into a central position,relative to the mating element 200, in an up and down direction (i.e.longitudinal direction) along the spine.

Once the plate 300 is centralised about the mating element 200, theapertures 310 in the plate 300 are used as guides to prepare holes inthe adjacent vertebrae. Following this, screws are then inserted throughthe apertures 310 into the prepared holes in the adjacent vertebrae.Once the screws are secured, the mating element 200 is then disconnectedfrom the implant 400, normally with the fastening element 100 attached.It would be appreciated that the mating element 200 is disconnected fromthe implant 400 by rotating the driving portion 244, with the firstdriver 500, in a direction to release the attaching portion 246 from thereleasably fixing portion 430.

The spinal fixation system 10 provides a temporary means for securingand accurately aligning the plate 300 during surgery. In particular, theinteraction between the two side portions 226 and the sidewalls 326centralise the plate 300 in a left to right direction (i.e. a lateraldirection) across a patient. Furthermore, the use of the wings 144allows the plate 300 to be centralised in an up and down direction (i.e.a forward and back direction or a longitudinal direction) along thepatient.

With the above in mind, as patients typically range in height and thealigning aperture 320 may change between different plates 300, the wings144 are able to accommodate these changes in size. For example, a longeraligning aperture 320 will cause the plate to engage further along thewing 144, but this will still allow the plate 300 to be centralisedabout the mating element 200. Moreover, movement of the plate 300 isminimised during insertion of the plate 300 into the patient, due to itsinteraction with the mating element 200.

In addition, when the plate 300 is fixed into position, the apertures310 in the plate 300 may be used as guides in preparing holes in theadjacent vertebrae. The limited movement of the plate 300 also assistsin aligning the screws that are inserted into said prepared holes of thepatient. This reduces the risk of the screws, plate 300 or alike cominginto contact and damaging adjacent structures that may, for instance, beneural or vascular.

In this specification, adjectives such as first and second, left andright, top and bottom, and the like may be used solely to distinguishone element or action from another element or action without necessarilyrequiring or implying any actual such relationship or order. Where thecontext permits, reference to an integer or a component or step (or thelike) is not to be interpreted as being limited to only one of thatinteger, component, or step, but rather could be one or more of thatinteger, component, or step etc.

The above description of various embodiments of the present invention isprovided for purposes of description to one of ordinary skill in therelated art. It is not intended to be exhaustive or to limit theinvention to a single disclosed embodiment. As mentioned above, numerousalternatives and variations to the present invention will be apparent tothose skilled in the art of the above teaching. Accordingly, while somealternative embodiments have been discussed specifically, otherembodiments will be apparent or relatively easily developed by those ofordinary skill in the art. The invention is intended to embrace allalternatives, modifications, and variations of the present inventionthat have been discussed herein, and other embodiments that fall withinthe spirit and scope of the above described invention.

In this specification, the terms ‘comprises’, ‘comprising’, ‘includes’,‘including’, or similar terms are intended to mean a non-exclusiveinclusion, such that a method, system or apparatus that comprises a listof elements does not include those elements solely, but may well includeother elements not listed.

What is claimed is:
 1. An alignment assembly for aligning andpositioning an interbody plate over a disc space in between two adjacentvertebrae, the assembly comprising: a fastener having a long axis and aplate engagement comprising opposed wings converging towards said longaxis; and a mate for the fastener configured to receive the fastenerthereover at a first end and having a releasable connector with areleasable attachment below the first end; wherein the fastener isreleasably secured to the mate for the fastener as it moves therealong;and wherein during use, the opposed wings contact one or more edges ofan aligning aperture of the interbody plate, thereby bringing theinterbody plate into alignment with the fastener.
 2. The alignmentassembly of claim 1 wherein the fastener includes an upper body having adriver engagement.
 3. The alignment assembly of claim 1 wherein thefastener comprises a lower body having the plate engagement.
 4. Thealignment assembly of claim 1 wherein said wings comprise respectiveplate engaging surfaces such that, in response to one of said wingsengaging with a front and/or rear wall forming said edges of thealigning aperture in the plate, the plate is configured to shift in adirection towards the other of said wings.
 5. The alignment assembly ofclaim 1 wherein the mate for the fastener comprises a body having twosides that are substantially flat.
 6. The alignment assembly of claim 5wherein a distance between the two sides is substantially the same as adistance between side walls in the aligning aperture of the plate. 7.The alignment assembly of claim 5 wherein the body of the mate for thefastener includes an aperture therethrough configured to receive thereleasable connector.
 8. The alignment assembly of claim 7 wherein thereleasable connector includes a shaft that is connected between areleasable attachment and a head.
 9. The alignment assembly of claim 8wherein the head is located above the body of the mate for the fastener.10. The alignment assembly of claim 1 further comprising the interbodyplate formed with the aligning aperture for receiving the mate for thefastener therethrough.
 11. The alignment assembly of claim 10 whereinthe plate comprises a first aperture, a second aperture, a thirdaperture and/or a fourth aperture located about the aligning aperture.12. The alignment assembly of claim 1 further comprising an implantconfigured to be received between adjacent vertebrae and to releasablyconnect with the releasable connector.
 13. A spinal fixation assemblycomprising the alignment assembly of claim 11 wherein the implant is inthe form of a spinal cage.